Healthcare Provider Details

I. General information

NPI: 1215937925
Provider Name (Legal Business Name): STANFORD ALVIN SINGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36700 WOODWARD AVE STE 300
BLOOMFIELD HILLS MI
48304-0926
US

IV. Provider business mailing address

36700 WOODWARD AVE STE 300
BLOOMFIELD HILLS MI
48304-0926
US

V. Phone/Fax

Practice location:
  • Phone: 248-203-6620
  • Fax: 248-203-0093
Mailing address:
  • Phone: 248-203-6620
  • Fax: 248-203-0093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301 025896
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: